MRS. BRENDA B CLARK PHYSICIANS ASSISTANT NPI 1417979576

NPI Information

  • NPI: 1417979576
  • Provider Name: MRS. BRENDA B CLARK, PHYSICIANS ASSISTANT
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • Address: 371 NC HWY 65
    SUITE204 ROCKINGHAM CO. DEPT OF PUBLIC HEALTH
    WENTWORTH, NC
    ZIP 27375
  • Phone: (336) 342-8140

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NPI Details

MRS. Brenda B Clark, PHYSICIANS ASSISTANT is a surgical physician assistant in Wentworth, NC. MRS. Brenda B Clark, PHYSICIANS ASSISTANT NPI is 1417979576. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

371 NC HWY 65
SUITE204 ROCKINGHAM CO. DEPT OF PUBLIC HEALTH
WENTWORTH, NC
ZIP 27375-204
Phone: (336) 342-8140
Fax: (336) 342-8356

The enumeration date for this NPI number is 7/24/2006 and was last updated on 7/3/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical100487NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12745729MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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